Jago Times "English Edition" Best Online Newspaper
As the world enters another calendar year of the COVID-19 pandemic, new variants of the coronavirus are being detected.
Variants of any virus are common and expected — but mutations in the virus that causes COVID-19 are particularly worrisome to health experts because of the danger they pose to unvaccinated people.
At-home COVID tests and appointments at private clinics and sites are becoming hard to find.
Most recently, health experts have been concerned about the omicron variant of the virus, which is thought to be much more contagious than the delta variant.
Experts in North Texas are preparing for a surge in cases and hospitalizations in the coming weeks as omicron takes its hold on the region.
But how do you know if you are infected with a variant of the virus? Here’s what you need to know:
Which variants are circulating in Dallas County?
The Centers for Disease Control and Prevention is monitoring two variants of concern of the virus that causes COVID-19: B.1.617.2, also known as delta, which was first detected in India; and B.1.1.529, also known as omicron, which was first detected in South Africa.
A variant of concern is classified by the CDC as any mutation of the virus for which there is evidence of increased transmissibility, more severe disease or a reduction in the effectiveness in treatments, vaccines or diagnostic tests.
Health experts say the omicron strain now accounts for the majority of cases in the United States. While early data suggests that omicron may cause less-severe disease, health experts say that may not translate to fewer hospitalizations if the overall number of infections is higher than what North Texas saw with the delta variant.
By Dec. 28, 542 instances of COVID-19 variants had been confirmed among Dallas County residents, including 344 cases of the delta variant and one case of the omicron variant.
The remaining variants detected in Dallas County residents are strains on the CDC’s list of variants being monitored, meaning they are either circulating at low levels or don’t pose a threat to public health.
How do health officials know who has a variant?
Although county health officials give regular updates about the number of confirmed variants among residents, local health experts say it’s not a complete picture.
“That is by no means comprehensive,” said Dr. Philip Huang, director of the Dallas County’s health department, referring to the county’s daily update of variant counts. “The message is that it just confirms that [a variant] is present and circulating in our community.”
Part of the total comes from positive tests taken by Dallas County that are sent to the state health department for analysis, Huang said. He said the county sends at least half of all its positive samples that meet certain criteria to the state.
The other portion of the total comes from analysis of tests by researchers at UT Southwestern Medical Center.
Dr. Jeffrey SoRelle, an assistant instructor in the department of pathology, is co-leading that effort. He and a team of researchers analyze COVID-19 tests from UTSW providers, some outside providers that are tested at UTSW, and some samples from Texas Health Resources.
The first step in the process is to take all positive COVID-19 tests and identify the ones that have a high enough viral load for them to be sequenced, or analyzed.
The amount of viral load in a COVID-19 test is almost entirely dependent on when a person is tested for the disease, SoRelle said. Viral load is usually higher when someone initially gets sick and then tapers off after about two weeks.
“It’s true that this is a small proportion of the total number of tests being performed,” he said. “But in general, the trends have tracked fairly well with what we’re seeing with statewide numbers, which at least gives us some confidence that there’s similar trends. When the UK alpha variant first arose, we saw it at similar levels at our institution as were being reported across other areas of Texas.”
Once researchers determine there is enough viral load in a test for sequencing, two processes are performed. The first process, called targeted PCR, gives the team a more general idea of the makeup of the virus.
“We look for about eight different mutations that might be present in some of the different variants of concern. This is a sort of snapshot, small picture, but can be quite sensitive,” SoRelle said.
The second process, known as whole genome sequencing, gives researchers an in-depth look at the genetic makeup of the virus.
“Base by base or nucleotide by nucleotide, we see if there’s any changes different from the original strain,” SoRelle said. “In many cases there’s many random mutations, but in the variants of concern, there are usually many specific mutations that can be recognized.”
An algorithm is then used to determine if the virus is one of the variants.
The whole process can take up to two weeks, he said.
“Our goal is to see if there are any variants in our population, and then see if there’s any novel variants that no one’s ever seen before,” SoRelle said.
The sequencing process doesn’t affect how quickly patients receive their COVID-19 test results.
Do individuals need to know whether they are sick with a variant?
SoRelle’s team notifies the public health department of any positive variants they detect. But neither UT Southwestern or the county health department notify individuals if they test positive for a variant.
Although the way tests are analyzed is not unique to the COVID-19 virus, the team doesn’t notify individuals because the type of test is used only for research purposes. He said there aren’t any tests approved for giving patients information about variants.
Health experts say on an individual level it doesn’t matter whether people know they tested positive for variants or not, because the guidance is the same no matter what mutation a person has.
“There is no difference. We don’t have a particular treatment based on your variant; we don’t have a particular protocol based on your variant,” said Dr. Marcial Oquendo, a pediatrician and a member of the Dallas County Medical Society. “At the end of the day, the recommendations for you as a person who’s infected, it doesn’t change based on whether it’s one or the other.”
But epidemiologists and other health experts need to know about variants in a community so they can better determine a community’s risk level based on how the virus is spreading.
Health experts are concerned that if vaccination rates slow, the variants will have adverse impacts on people who haven’t gotten shots.
“Now that we’ve somewhat to a degree plateaued or hit this little bit of a lull in individuals getting vaccination, that’s our concern,” said Dr. Mark Casanova, former president of the Dallas County Medical Society. “There’s enough dry wood in the pile that this next wave has enough fuel to set off another fire. Now, will it be a raging blaze, like last summer, last winter? No, but it’s going to be a fire nonetheless.”
At this stage of the pandemic, health experts say severe outcomes of the disease, like hospitalization and death, are preventable on an individual level. The fact that more transmissible variants of COVID-19 are circulating should motivate people to get vaccinated and boosted.
“It’s more important for the individual to know that, ‘Hey, listen, this isn’t the COVID of 2020. This is the COVID of 2021,’” Casanova said.